腹腔镜胃癌D2根治术与传统开腹胃癌D2根治术疗效与安全性比较.docVIP

腹腔镜胃癌D2根治术与传统开腹胃癌D2根治术疗效与安全性比较 　　[摘要] 目的 比较研究腹腔镜胃癌D2根治术与传统开腹胃癌D2根治术的疗效与安全性。 方法 选取本院2009年3月～2013年2月收治的406例胃癌患者作为研究对象，参照患者选取的手术方式将其分为腹腔镜组206例与开腹组200例，其中腹腔镜组胃癌患者行腹腔镜D2根治术，开腹组胃癌患者行传统的开腹D2根治术，比较总结两组患者的治疗效果与并发症发生情况。 结果 腹腔镜组患者的手术治疗切口长度、术中出血量、术后恢复进程等方面与开腹组比较，差异有统计学意义（P 　　[关键词] 胃癌；开腹胃癌D2根治术；腹腔镜根治术；疗效比较；安全性 　　[中图分类号] R735.2 [文献标识码] A [文章编号] 1674-4721（2013）11（b）-0024-03 　　Comparison on curative effect and safety between D2 dissection of gastric cancer with laparoscope and traditional laparotomy 　　LIU Hong-quan LIU Chuan-yuan FANG Chuan-fa 　　General Surgery Department，People′s Hospital of Ganzhou City in Jiangxi Province，Ganzhou 341000，China 　　[Abstract] Objective To compartive study the curative effect and safety between D2 dissection of gastric cancer with laparoscope and traditional laparotomy. Methods 406 cases of patients with gastric cancer treated in our hospital from March 2009 to February 2013 were selected as research objects.According to surgical method，they were divided into laparoscopy group （206 cases） and laparotomy group （200 cases）.Gastric cancer patients in laparoscopy group were given laparoscopic D2 dissection，and gastric cancer patients in laparotomy group were given D2 dissection with traditional laparotomy，therapeutic effect and complications of patients in two groups were compared and summarized. Results The length of incision，bleeding volume，postoperative recovery process on patients of laparoscopy group compared with the laparotomy group，the difference was statistically significant （P10 cm、腹腔粘连、胃癌急症手术及器官功能障碍、手术耐受不良等患者。参照患者自主选择的治疗方式将其分为腹腔镜组与开腹组。其中，腹腔镜组患者206例，男性166例，女性40例，平均年龄（43.7±11.5）岁，腹腔镜根治组行腹腔镜全胃根治术患者70例，腹腔镜远端胃癌根治术患者116例，近端胃癌根治术患者20例；开腹组胃癌患者200???，男性160例，女性40例，年龄25～76岁，平均年龄（42.1±9.8）岁，行全胃D2根治术患者48例，远端胃癌D2根治术患者132例，近端胃癌根治术患者20例。两组患者的年龄、性别、病程、TNM分期等级及病情等差异无统计学意义（P0.05），具有可比性。 　　1.2 方法 　　腹腔镜组：腹腔镜组胃癌患者主要实施腹腔镜胃癌D2根治术。患者行全身麻醉且行气管内插管，术中患者两腿分开取平卧体位（手术实施过程中主治医师于患者左侧，医护助理于患者右侧，腹腔镜扶手于患者双腿间，便于手术的实施）[5]。行脐孔穿刺，向患者腹腔内冲入CO2气体，且术中患者腹腔气压维持在12～15 mm Hg（1.596